Brief intervention for female heavy drinkers in routine general practice: a 3-year randomized, controlled study.

BACKGROUND: Today, heavy drinking is a common health hazard among women. The evidence in favor of providing some kind of brief intervention to reduce drinking is quite convincing. However, we do not know if intervention works in a natural environment of routine health care. The purpose of this study was to evaluate the effectiveness of long-lasting, brief alcohol intervention counseling for women in a routine general practice setting. METHODS: In five primary care outpatient clinics in a Finnish town, 118 female early-phase heavy drinkers who consulted their general practitioners for various reasons were given brief alcohol intervention counseling. Intervention groups A (n = 40) and B (n = 38) were offered seven and three brief intervention sessions, respectively, over a 3-yr period. The control group C (n = 40) was advised to reduce drinking at baseline. Main outcome measures were self-reported weekly alcohol consumption, carbohydrate-deficient transferrin, mean corpuscular volume (MCV), aspartate aminotransferase, alanine aminotransferase, and gamma-glutamyltransferase. RESULTS: Depending on the outcome measure and the study group, clinically meaningful reduction of drinking was found in 27% to 75% of the heavy drinkers. Within all the groups, MCV significantly decreased. However, there were no statistically significant differences between study groups A, B, and C in the mean changes between the beginning and endpoint in the main outcome measures. CONCLUSIONS: The present study indicated that minimal advice, as offered to group C, was associated with reduced drinking as much as the brief intervention, as offered to groups A and B, given over a 3-yr period. Furthermore, in the routine setting of the general practice office, the effectiveness of the brief intervention may not be as good as in special research conditions. The factors possibly reducing the effectiveness in a routine setting are unknown. Thus, different methods of implementing brief intervention need to be evaluated to find better ways to support general practice personnel in their efforts to help heavy-drinking female patients to reduce their drinking.

Clinical laboratory results of vanadium-exposed workers.

Vanadium pentoxide exposure and its effect on select hematologic and chemical laboratory tests for workers exposed to 0.2-0.5 mg/m3 vanadium was studied. No association was found between vanadium exposure and the results of laboratory tests. The values of some chemical laboratory tests differed from those of controls. These findings, however, were not considered to be clinically significant because the mean values differed only slightly from each other. Hematologic tests showed no abnormalities when the concentration of vanadium in the factory air was 0.01-0.04 mg/m3.

Serum and urinary vanadium of workers processing vanadium pentoxide.

Serum and urinary vanadium concentrations were investigated in eight men exposed to vanadium pentoxide dust. The creatinine-adjusted urinary vanadium concentrations were found to correlate with serum vanadium concentrations (r = 0.81), but not with the vanadium contents of factory air. The urinary vanadium excretion decreased significantly with the time the workers spent out of exposure. At the beginning of their summer holidays the serum vanadium concentration of the workers was 393 +/- 223 (S.D.) nmol/l and the urinary excretion of vanadium 73 +/- 50 nmol/mmol of creatinine. Three days after exposure the urinary excretion of vanadium was 46 +/- 24 nmol/mmol of creatinine. On the 16th day of their holidays vanadium could be detected in the serum (225 +/- 83 nmol/l) and in the urine (48 +/- 26 nmol/mmol of creatinine) of the workers. Eight family members of the exposed had less vanadium in urine (32 +/- 17 nmol/mmol of creatinine). These results suggest that most of the absorbed vanadium is excreted in the urine within one day after a long-term moderate exposure to vanadium dust.

Intracellular immunoglobulins in plasma cells of nasal biopsies taken from vanadium-exposed workers. A retrospective case control study by the peroxidase-antiperoxidase (PAP) method.

The amount and classes of immunoglobulins were determined in plasma cells of nasal biopsies taken from vanadium-exposed workers, by peroxidase-antiperoxidase (PAP) method. Antiserum 1: 100 dilution proved better than 1: 1000 dilution in demonstrating the immunoglobulins in the formalin-fixed paraffin-embedded nasal biopsies stored four years. The number of plasma cells of the exposed was found to be increased, but no reliable conclusions could be drawn from the amounts of immunoglobulins in this survey. The number of positive cells had decreased probably due to storage and perhaps to fixation method, too (10% formalin). However, these findings seem to support our previous suggestion that vanadium does not cause an allergic nasal inflammation.

Observations on the lungs of vanadium workers.

Out of a total of 79 employees at a factory making vanadium pentoxide from magnetite ore 63 were investigated by respiratory questionnaire, chest radiography, and tests of ventilatory function. The findings were compared with a reference group of 63 men, matched for age (to within two years) and for smoking habit (to within five cigarettes daily) selected from workers at a magnetite ore mine. Analysis of the ventilation tests showed no significant differences between the reference group and the men exposed to low concentrations of vanadium (0.01--0.04 mg/m3), despite previous exposure for an average of 11 years to concentrations in the range of 0.1 to 3.9 mg/m3. Complaint of wheezing was significantly more common among the workers exposed to vanadium than among their referents, but there were no other subjective differences between the groups. Localized fibrotic foci were reported in the radiographs of four reference cases and two men exposed to vanadium, but there were no cases of pneumoconiosis in either group.

Serum and urinary vanadium of vanadium-exposed workers.

In this investigation the environment of vanadium workers was studied. It was found that low concentrations of vanadium (0.01--0.04 mg/m3) in the air do not correlate with vanadium serum levels or its urinary excretion. The results, however, suggest that values of vanadium in serum and urine samples reflect absorption of vanadium because vanadium could not be detected in the urine of referents. In higher vanadium exposure (0.2--0.5 mg/m3), the concentration in the air inhaled remaining unknown due to the use of dust masks, urinary vanadium excretion and serum vanadium level decreased significantly with exposure-free time.

Effects of vanadium on the upper respiratory tract of workers in a vanadium factory. A macroscopic and microscopic study.

An epidemiologic cross-sectional case-history study on the injurious effects of vanadium was carried out among the workers of a vanadium factory. The upper respiratory tract of 63 male workers exposed to vanadium dust was examined macroscopically and microscopically, and the findings were compared with those of a reference group of workers who were exposed to inert dust only. The groups compared were of similar ages and had similar smoking habits. Nasal smears and sputum cells were studied microscopically, and biopsies for histological study were taken from the nasal mucosa. The biopsies from the vanadium workers showed a significant increase in the number of plasma and round cells, and the histological picture was almost characteristic. There were no increased numbers of secretion eosinophils or other signs indicative of allergic inflammation.